But there is no reason to believe that glucose-induced damage is limited only to diabetics, or to those with metabolic syndrome, in whom blood sugar is also chronically elevated. Glycation and oxidation accompany every fundamental process of cellular metabolism. They proceed continuously in all of us. Anything that raises blood sugar—in particular, the consumption of refined and easily digestible carbohydrates—will increase the generation of oxidants and free radicals; it will increase the rate of oxidative stress and glycation, and the formation and accumulation of advanced glycation end-products. This means that anything that raises blood sugar, by the logic of the carbohydrate hypothesis, will lead to more atherosclerosis and heart disease, more vascular disorders, and an accelerated pace of physical degeneration, even in those of us who never become diabetic.

Chapter 12

Chapter Twelve

SUGAR

M. Delacroix, a writer as charming as he is prolific, complained once to me at Versailles about the price of sugar, which at that time cost more than five francs a pound. “Ah,” he said in a wistful, tender voice, “if it can ever again be bought for thirty cents, I’ll never more touch water unless it’s sweetened!” His wish was granted….

JEAN ANTHELME BRILLAT-SAVARIN, The Physiology of Taste, 1825

WHEN BIOCHEMISTS TALK ABOUT “SUGAR,” they’re referring to a whole host of very simple carbohydrate molecules, all of which are characterized, among other things, by their sweet taste and ability to dissolve in water. Their chemical names all end in “-ose”—glucose, fructose, and lactose, among others. When physicians talk about blood sugar, they’re typically talking about glucose, although other sugars can be found in the bloodstream at very much lower concentrations. Then there’s the common usage of “sugar,” meaning the sweet, powdered variety that we put in our coffee or tea. This is sucrose, which in turn is constituted of equal parts glucose and fructose. In the discussion to come, when we refer to “sugar” we’ll always be talking about sucrose. When we use the term “blood sugar,” we’ll be talking about glucose.